Process Evaluation on Crisis Services in Northern Idaho

Background: Idaho ranks last of all states for per capita spending on mental health treatment (Kaiser Family Foundation, 2014). In Idaho, individuals in crisis who suffer from mental illness or Substance Use Disorder (SUD) have few options for care. They often utilize the most expensive treatment through the emergency department, inpatient services, or by going to jail. Idaho has the 7th highest suicide rate in the nation (Suicide Prevention Action Network of Idaho, 2015), while Region 1 of Idaho has the second highest suicide rate in the state from 2010-2014 (Suicide Prevention Action Network of Idaho, 2015). Methods: This scholarly project uses process evaluation as a method to assist in the transformative work to improve crisis services in Region 1 of Idaho for the behavioral health population. This process evaluation focuses on three objectives: (1) to identify community goals and best practices from the international and national literature that have been shown to effectively respond to community behavioral health crises; (2) to determine how closely key stakeholders in the Region 1 behavioral health coalition agree with each other in addressing behavioral health crises and if they recognize community goals and best practices shown to effectively respond to behavioral health crises; and (3) to conduct a gap analysis that will identify the gaps and challenges in behavioral health crisis services and resources in Region 1. Results: (1) The literature revealed that there are two best practice goals that are shown to effectively help communities address behavioral health crises; multi-sectoral and suicide prevention approaches; (2) Interview responses of key stakeholders reflect criteria that are associated with a multi-sectoral approach and each agency had long-term goals to address the behavioral health population. However, there was not full agreement on the most urgent community-wide behavioral health crisis needs in Region 1; (3) Gaps in Region 1 were identified as lack of providers, lack of adequate transportation, lack of financial assistance for medications, and lack of housing for the behavioral health population. While most gaps are defined as a best practice in the literature, six gaps are unique to Region 1 and do not meet the definition of a best practice. This suggests that gaps and best practices may be unique to different communities and merits further exploration. Recommendations: The findings of this process evaluation have the potential to shape the direction of Region 1 behavioral health crisis services. It can provide the foundation for prioritizing best practice strategies for the region. Ultimately, the goal is to decrease suicide by addressing the identified gaps and lack of related best practices in Region 1 for the behavioral health population in crisis

Sleep spindle deficits in antipsychotic-naïve early course schizophrenia and in non-psychotic first-degree relatives

Introduction: Chronic medicated patients with schizophrenia have marked reductions in sleep spindle activity and a correlated deficit in sleep-dependent memory consolidation. Using archival data, we investigated whether antipsychotic-naïve early course patients with schizophrenia and young non-psychotic first-degree relatives of patients with schizophrenia also show reduced sleep spindle activity and whether spindle activity correlates with cognitive function and symptoms. Method: Sleep spindles during Stage 2 sleep were compared in antipsychotic-naïve adults newly diagnosed with psychosis, young non-psychotic first-degree relatives of schizophrenia patients and two samples of healthy controls matched to the patients and relatives. The relations of spindle parameters with cognitive measures and symptom ratings were examined. Results: Early course schizophrenia patients showed significantly reduced spindle activity relative to healthy controls and to early course patients with other psychotic disorders. Relatives of schizophrenia patients also showed reduced spindle activity compared with controls. Reduced spindle activity correlated with measures of executive function in early course patients, positive symptoms in schizophrenia and IQ estimates across groups. Conclusions: Like chronic medicated schizophrenia patients, antipsychotic-naïve early course schizophrenia patients and young non-psychotic relatives of individuals with schizophrenia have reduced sleep spindle activity. These findings indicate that the spindle deficit is not an antipsychotic side-effect or a general feature of psychosis. Instead, the spindle deficit may predate the onset of schizophrenia, persist throughout its course and be an endophenotype that contributes to cognitive dysfunction

Is American Public Administration Detached From Historical Context?: On the Nature of Time and the Need to Understand It in Government and Its Study

The study of public administration pays little attention to history. Most publications are focused on current problems (the present) and desired solutions (the future) and are concerned mainly with organizational structure (a substantive issue) and output targets (an aggregative issue that involves measures of both individual performance and organizational productivity/services). There is much less consideration of how public administration (i.e., organization, policy, the study, etc.) unfolds over time. History, and so administrative history, is regarded as a “past” that can be recorded for its own sake but has little relevance to contemporary challenges. This view of history is the product of a diminished and anemic sense of time, resulting from organizing the past as a series of events that inexorably lead up to the present in a linear fashion. To improve the understanding of government’s role and position in society, public administration scholarship needs to reacquaint itself with the nature of time.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

The Nutritional Impacts of European Contact on the Omaha: A Continuing Legacy

For the majority of Native American tribes on the Great Plains, contact with Euro-Americans resulted in a number of changes in their lifeways. For the Omaha tribe, the introduction of both the horse and firearms meant a diversification in nutritional strategies and a florescence in their culture. After being confined to their reservation in 1855, the Omaha continued to remain largely self-sufficient in food production. During the early years of the reservation until the turn of the century, the Omaha were highly successful farmers, producing surpluses of cash• and garden variety crops. In this paper I argue that today the situation is quite different. Few Omaha are able to produce their own food as most of their land has either been sold or leased. The tribe s dependency on processed, store-bought foods and government commodities has increased dramatically in the last fifty years. From an analysis of changing foodways over the past 200 years I conclude that, associated with this dependency, is a marked increase in chronic dietary diseases such as diabetes and obesity

Political and Social Implications of Possible Climatic Changes

There is something rather ludicrous about a learned paper on the political and social implications of the end of the world. Obviously, since we do not have much reliable historical information about this sort of event, the author can only offer some speculations which, however well-informed, are of debatable quality. And the reader, insofar as he or she actually believes in impending disaster, will doubtless be disappointed by the absence of any specific recommendations about how to survive. Yet while this exercise may seem foolish, it is undertaken because of the conviction that it would be even more foolish for our society to continue as if drastic climatic change were an impossibility

Native Americans, The Courts and Water Policy: Is Nothing Sacred?

Public policy in such areas as the environment is increasingly being shaped by the courts as they resolve conflicts. There is some question whether the courts are able to include in policy decisions those values that are not derived from economic utility. In this article, the values represented by traditional Native American beliefs about nature and particularly water are examined. While Native Americans have won some court battles over water, the judges have usually decided on the basis of contractual and treaty agreements and not on the basis of the preservation of traditional values. Cases arising in the Great Plains reflect this tendency in judicial thinking

Food Security and Housing in Vancouver’s Downtown Eastside

The purpose of this report is to document the housing and food security needs of the hard to house population in Vancouver’s Downtown Eastside and to provide population‐specific suggestions for policies to address these needs. The intersection between food security and housing has seen an increasing amount of activity in terms of programming but little in the way of research or policy. The report provides three categories of evidence: 1) academic research findings regarding the relationship between food security and health among vulnerable populations, 2) interviews with residents of the DTES regarding the food security issues they face and 3) focus groups and interviews with food and housing providers in the DTES on what types of infrastructure, programming and building contexts are most critical for enhancing food security and housing in the neighbourhood.Non UBCUnreviewedFacult

Assessing the Pocket Market Model for Growing the Local Food Movement: A Case Study of Metropolitan Vancouver

In this study we explore the pocket market model, an emergent alternative retail marketing arrange­ment for connecting urban consumers with local food producers. In this model, community-based organizations act as local food brokers, purchasing fresh, healthful food from area farmers and food producers, and selling it to urban consumers in small-scale, portable, local food markets. The benefits of pocket markets are numerous. They include the provision of additional and more local­ized marketing outlets for local food producers; increased opportunities to educate consumers about local food and sustainable food systems; the convenience for consumers of having additional venues where local food is available for purchase; and an ability to increase access to fresh produce in areas with poor or limited retail food options. Despite these advantages, pocket market organiz­ers face many challenges in implementing this model successfully. These include a lack of public familiarity with the pocket market concept, an inability to address issues of food access in a way that is financially sustainable, and issues related to logistics, site selection, and regulatory requirements. In this paper, we will explore the pocket market model using those operating in metropolitan Vancouver (British Columbia, Canada) as an example, and assess the degree to which it addresses some of the current gaps in bringing local food to urban communities